{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:45:37Z","timestamp":1789076737603,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T00:00:00Z","timestamp":1488153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Mothers carrying anti\u2010Ro antibodies are frequently referred for weekly echocardiograms to early detect and treat antibody\u2010mediated fetal heart disease. We tested a surveillance strategy based on anti\u2010Ro antibody titers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 2009 to 2014, 232 pregnancies were referred for maternal anti\u2010Ro antibodies. At the baseline echocardiogram, anti\u2010Ro titers were measured by enzyme\u2010linked immunosorbent essay and results categorized as negative (&lt;8\u2009U\/mL; <jats:italic>n<\/jats:italic>\u2009=\u200943; excluded), low\u2013moderate positive (8\u201349\u2009U\/mL; <jats:italic>n<\/jats:italic>\u2009=\u200962; group 1) or high positive (50 \u2013 &gt;100\u2009U\/mL; <jats:italic>n<\/jats:italic>\u2009=\u2009127; group 2). Serial echocardiograms to \u226524\u2009weeks were only recommended for group 2 mothers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Group 1 patients underwent significantly less fetal echocardiograms when compared with group 2 mothers (median 2 vs. 4; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Isolated endocardial fibroelastosis (<jats:italic>n<\/jats:italic>\u2009=\u20091) and incomplete (<jats:italic>n<\/jats:italic>\u2009=\u20094) or complete (<jats:italic>n<\/jats:italic>\u2009=\u20094) heart block were diagnosed in 9 (8%) pregnancies with anti\u2010Ro titers &gt;100\u2009U\/mL but none with lower titers (odds ratio 17.78; <jats:italic>p<\/jats:italic>\u2009=\u20090.004). Incomplete block and endocardial fibroelastosis regressed with transplacental corticosteroid and immune globulin therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Limiting serial fetal echocardiograms to women with high anti\u2010Ro antibody levels is safe and more cost effective. While numbers of echocardiograms were significantly reduced in referrals with anti\u2010Ro titers &lt;50\u2009U\/mL, reversible abnormalities with prenatal treatment were detected by serial echocardiography in group 2 patients. \u00a9 2017 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.5021","type":"journal-article","created":{"date-parts":[[2017,2,8]],"date-time":"2017-02-08T14:12:48Z","timestamp":1486563168000},"page":"375-382","source":"Crossref","is-referenced-by-count":47,"title":["Serial echocardiography for immune\u2010mediated heart disease in the fetus: results of a risk\u2010based prospective surveillance strategy"],"prefix":"10.1002","volume":"37","author":[{"given":"Nobuhiko","family":"Kan","sequence":"first","affiliation":[{"name":"Fetal Cardiac Program, Labatt Family Heart Centre, Hospital for Sick Children University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Earl D.","family":"Silverman","sequence":"additional","affiliation":[{"name":"Department of Immunology Hospital for Sick Children, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kingdom","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Mount Sinai Hospital, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Dutil","sequence":"additional","affiliation":[{"name":"Fetal Cardiac Program, Labatt Family Heart Centre, Hospital for Sick Children University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Laskin","sequence":"additional","affiliation":[{"name":"Department of Medicine Mount Sinai Hospital, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9012-6592","authenticated-orcid":false,"given":"Edgar","family":"Jaeggi","sequence":"additional","affiliation":[{"name":"Fetal Cardiac Program, Labatt Family Heart Centre, Hospital for Sick Children University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,27]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.707661"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199911)42:11<2335::AID-ANR12>3.0.CO;2-3"},{"key":"e_1_2_5_4_1","first-page":"120","article-title":"Importance of the immune response to the Ro\/La particle in the development of congenital heart block and neonatal lupus erythematosus","volume":"18","author":"Silverman E","year":"1991","journal-title":"J Rheumatol"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/03009742.1998.11720702"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker515"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00161-2"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20126"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437597.44550.5d"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200108)44:8<1832::AID-ART320>3.0.CO;2-C"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-23555"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20554"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem073"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.12.014"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.02.042"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.093070"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000142046.58632.3A"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.09.044"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.773143"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200005)43:5<1049::AID-ANR13>3.0.CO;2-X"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200101)44:1<242::AID-ANR34>3.0.CO;2-S"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.07.002"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02004-1"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.10.059"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1067\/mje.2002.121438"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2004.10.023"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1191\/0961203302lu173oa"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198501103120206"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10716"}],"container-title":["Prenatal Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpd.5021","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.5021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T15:22:35Z","timestamp":1695568955000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pd.5021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,27]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["10.1002\/pd.5021"],"URL":"https:\/\/doi.org\/10.1002\/pd.5021","archive":["Portico"],"relation":{},"ISSN":["0197-3851","1097-0223"],"issn-type":[{"value":"0197-3851","type":"print"},{"value":"1097-0223","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,27]]}}}